Student Nurses. Kenepuru Operating Theatres

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1 Student Nurses Kenepuru Operating Theatres Tracey Doyle Page 1 2/3/2016

2 Kia Ora We are looking forward to working with you. Kenepuru Peri-operative Unit consists of Admission and Discharge areas, three Operating Theatres, an Advanced Procedures Unit and a Post Anaesthetic Care Unit (Recovery). We provide elective surgery for patients requiring a variety of procedures including Orthopaedic, Gynaecology, General Surgery, Ophthalmology, Urology, Dental, Ear Nose & Throat (ENT), Paediatric, Renal, and Endoscopy. Kenepuru Peri-Operative Unit provides services for patients who require day surgery, and patients requiring post-operative care in hospital. All patients are admitted on the day of surgery and are either discharged home the same day, or discharged to the Kenepuru Surgical Unit (KSU). Occasionally, patients are transferred from Wellington Hospital and are held in KSU. We have both full time and part time staff including: a Charge Nurse Manager (CNM), Registered Nurses (RNs), Anesthetic Technicians, HealthCare Assistants (HCAs), technical assistant and administrative/reception staff. Tracey Doyle Page 2 2/3/2016

3 Some Procedures you will see at Kenepuru Operating Theatres DENTAL Extractions Restorations Excision of abscesses Dental scale X-rays Oral surgery OPHTHALMOLOGY Cataract extraction and lens implant Squint correction Pterygium excision Corneal grafts Trabeculectomy Eye Lid Surgery including entropian/ectropian repair GYNAECOLOGY Diagnostic Laparoscopy Diagnostic Hysteroscopy Total Abdominal Hysterectomy Vaginal Hysterectomy Excision of cysts Laparoscopic diathermy/excision of endometriosis Vaginal repairs ORTHOPAEDICS Total / Uni/ Knee Joint Replacement Total Hip Joint Replacement Open Reduction Internal Fixation (ORIF) of fractured bones / removal of internal fixation Carpal Tunnel decompression Dupuytrens contracture release Manipulation under anaesthetic Arthroscopic examination of joints EAR, NOSE & THROAT (ENT) Insertion or removal of grommets Removal of foreign bodies Removal of Adenoids Tracey Doyle Page 3 2/3/2016

4 PAEDIATRIC Orchidopexy Herniorrhaphy Circumcision EUA GENERAL SURGERY Laparoscopic Cholecystectomy Herniorrhaphy Minor Breast Surgery Pilonidal Sinus Repair Hydrocele Repair Orchiectomy RENAL Arterio-Venous fistula formation/closure/review ENDOSCOPY Gastroscopy Colonoscopy Flexible Sigmoidoscopy UROLOGY Circumcisions Hydrocele Repair Hypospadias Repair Scrotal cyst excisions Orchiectomy Contacts Kenepuru Theatres Clinical Manager Ros Hpa Ext 7094 Student coordinator Tracey Doyle Ext7365 or Tracey Doyle Page 4 2/3/2016

5 Your Preceptor You will be allocated a preceptor who will manage your learning during this placement. It is unlikely that you will be able to work with this nurse through all areas, but we will try to ensure that you will be with one or two people in each area. Our aim is to give you continuity on your placement. It is helpful to check the day before your next shift who your preceptor is and what time your shift starts, as the nursing staff work in multiple specialties and areas in our unit. If you are unavailable for work on a particular day please inform your preceptor or call the main phone line provided for theatres and leave a message with the staff member who answers. HOURS This unit is open from 0700hrs 1800hrs Monday to Friday. Peri-operative staff work as detailed below: Admission 0700hrs 1530hrs, 0730hrs 1600hrs & 0800hrs -1630hrs Discharge (Stage II Recovery) 0830hrs -1700hrs, 0900hrs 1730hrs, & 0930hrs 1800hrs. Theatre 0800hrs 1630hrs. Recovery 0800hrs 1630hrs, 0900hrs 1730hrs & 0930hrs 1800hrs. Tracey Doyle Page 5 2/3/2016

6 ROLE OF THE THEATRE NURSE The role of the nurse in theatre is a very important one. Peri-op and Recovery are slightly different as you get nurse / patient interaction where as in theatre we focus intensely on patient advocacy and safety. As the patient is anaesthetised, it is the theatre nurses job to advocate for their needs and to ensure they are safe throughout the procedure. These principles will be outlined to you during you placement. We have a few expectations of student nurses working in the Kenepuru Operating theatre unit: It is expected that you arrive on time for your shift and if you are going to be late or you are unwell and can not come to call the unit on You must complete the full shift that you are allocated to work if you are unable to do so please discuss this with your preceptor. A lot of learning occurs at quiet times in the unit!! It is important for your preceptor you are working with that he/she is aware of your objectives. Due to infection control fresh clean scrubs must be worn each shift, long hair must be tied back and all jewelry removed. No street clothing is permitted to be worn underneath or over top of the scrubs and shoe covers are to be worn over regular shoes. Always display your I.D badge. If you are not achieving your objective please see the student coorinator or your preceptor (before the end of the week in the unit) Please ensure all documentation you need to complete for the polytechnic/university is accomplished before the last days in the unit your preceptor will not complete any paper that is given to him or her if it is given in the last days of your placement. Tracey Doyle Page 6 2/3/2016

7 RESOURCES Staff Anaesthetics - Pat Glasgow / Colin Hale Orthopaedic - Zoe Perkins Ophthalmology - Jen Cowell Gynaecology - Catherine Curran Peri-operative - Lynda Goulden Endoscopy - Lynley McKeich ENT - Vasanthi Ammasee Recovery - Bridget McPhail Renal - TraceyDoyle/Vasanthi Ammasee Paediatrics - Christine Hughes General - Emma Brooks Urology - Tracey Doyle Text Books Text books, literature and Journals are available in our Resource Room and in Recovery. All Nurses will be able to answer any questions or concerns, but please feel free to approach the above people for more specific enquiries. Treasure Hunt Please complete this treasure hunt on your first day. 1. Fire Hoses x2 2. Fire Extinguishers x2 3. Resuscitation Trolley 4. Patient bathrooms / staff bathroom 5. Charge Nurse Manager office 6. Emergency button in Peri-op and Recovery 7. Sterile / non-sterile store rooms 8. Linen cupboard 9. Tea room 10. Roster 11. Recycling bin Tracey Doyle Page 7 2/3/2016

8 Safety Measures and education in the Kenepuru Theatres The most important safety measure that can be undertaken by the student nurse is to ensure that they are familiar with the environment that they work within. We are lucky in that we work along side highly trained and skilled doctors who tend to take the lead in medical emergencies but that does not mean that as nurses we can rely on that fact alone. We may also be leading the medical intervention in relevant emergencies and so it is important that as nurses we are trained, skilled and vigilant in these situations. During your orientation of the facility and while completing the Treasure Hunt some of the emergency equipment, resus. trolley, and difficult airway trolley, etc will be shown to you as well as an explanation as to your role in a emergency. From time to time we practice medical emergencies within the theatres and if you are lucky enough to be part of the exercise, please treat this as the pinnacle of learning exposure, a great deal can be learnt from participation and observation of these scenarios. Once a month education sessions are provided for staff on topics that are relevant to this unit. They are presented by the staff of this unit, reps and members of other faculties. You are welcome to join in on these sessions. Tracey Doyle Page 8 2/3/2016

9 Objectives during you placement We expect you to commence this placement with basic learning objectives. After the first week you will have a greater understanding of the Perioperative processes and be able to refine your learning objectives accordingly. Some examples are: Accurate assessment Competent implementation of care Documentation Gain an understanding of the multidisciplinary team Practice good infection control measures Patient advocacy Pain and wound management Fluid management/fluid balance Pre- reading. Copies of appropriate policies are available to students on arrival at the unit to help with their learning, i.e gowning and gloving, perioperative attire and aseptic technique. Common Medications used in the perioperative environment you may be interested in: Panadol/Pamol Midazelam Fentanyl Propofol Ondansetron Morphine Tramadol Dexamethisone Cephazolin Dinastat Suxamethonium Tracey Doyle Page 9 2/3/2016

10 Evaluation of Clinical Experience Nurse: Date of placement: Date of Evaluation: Preceptor: This evaluation is intended to offer feedback to the preceptor and their clinical area. Clinical Learning 1 Strongly Agree The staff were welcoming and learned to know the students by their personal name The staff were easy to approach and generally interested in student supervision A preceptor(s) was identified/introduced to me on arrival to area One preceptor had an overview of my experience and completed my assessment An orientation to the clinical area was provided My learning objectives were achieved 2 Agree 3 Neither agree or disagree 4 Disagree 5 Strongly disagree Comments I felt integrated into the nursing team I formally met with the named preceptor at least fortnightly There were sufficient meaningful learning situations in the clinical placement How was the Preceptor? The preceptor assessed and acknowledged my previous skills and knowledge The preceptor discussed my prepared learning objectives The preceptor assisted with planning learning activities The preceptor supported me by observing and supervising my clinical practice The preceptor was a good role model for safe and competent clinical practice I felt comfortable asking my preceptor questions The preceptor provided me with regular constructive feedback on my practice Please return this form to the Charge Nurse Manager Tracey Doyle Page 10 2/3/2016